Evidence map›Paper›PMID 41087081›Full record

Trial reportArchives of disease in childhood. Fetal and neonatal edition2026

Cerebral fuels within the first week of life in very preterm infants: a cohort study.

Gordon Xin Hua Liu, Loredana Marcovecchio, K Beardsall, REACT Collaborative

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Archives of disease in childhood. Fetal and neonatal edition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Gordon Xin Hua LiuSchool of Medicine, University of Auckland-Grafton Campus, Auckland, New Zealand.ORCID http://orcid.org/0000-0002-4261-9683
Loredana MarcovecchioDepartment of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.ORCID http://orcid.org/0000-0002-4415-316X
K BeardsallDepartment of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK kb274@cam.ac.uk.ORCID http://orcid.org/0000-0003-3582-183X
REACT Collaborative

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKetones and lactate may contribute towards overall cerebral fuel availability in term infants, yet the availability of such cerebral fuels in very preterm infants is unclear. We undertook a prespecified substudy to explore ketone and lactate concentrations in the first week of life in infants recruited to the REACT trial (real-time continuous glucose monitoring in the newborn): an international multicentre randomised controlled trial of 182 very low birth weight infants investigating the use of continuous glucose monitoring in glycaemic care.

methodsKetone and lactate measurements were prospectively collected over the first week of life using the Nova Biomedical point-of-care meter. A longitudinal analysis was undertaken to explore lactate and ketone concentration trends across time and their relationships with blood glucose, baseline demographics, nutritional support and insulin treatment.

resultsData were available for 168 infants (85 females) including 2902 blood glucose, 2084 ketone and 2017 lactate samples. The mean (SD) gestational age was 27.4 (2.0) weeks. Lactate concentrations were higher initially, with mean (SD) 1.72 (1.26) mmol/L on day 2 and lowered to 1.19 (1.1) mmol/L on day 7. Ketone concentrations remained consistently low at 0.1 mmol/L. Neither simultaneous blood glucose concentrations, macronutrient intake nor receipt of insulin was consistently related to ketone or lactate concentrations.

conclusionIn this cohort of very preterm infants, there were persistently low concentrations of ketones and relatively higher concentrations of lactate throughout the first week of life. Future research should evaluate changes in these metabolites during episodes of acute hypoglycaemia or hyperglycaemia over more prolonged periods of neonatal intensive care.

Indexed as

Blood GlucoseInfant, Extremely PrematureInfant, Very Low Birth WeightKetonesLactic AcidFemaleGestational AgeHumansHypoglycemiaInfant, NewbornInfant, PrematureMaleProspective StudiesBlood GlucoseKetonesLactic AcidEndocrinologyNeonatology

Identifiers

PMID41087081
PMCPMC13151478

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.